Jan Ford, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

26NJ00922600 Issued in NJ

Practice address

500 Main St Ste 1
Lanoka Harbor, NJ 08734-2228

Phone

(732) 719-1920

Fax

(732) 719-1920

NPI assigned

May 21, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/11700/brand/1/csg/1/fhir/r4
• Direct secure messaging: hackensackmeridian.janford@136290.advancedmd-direct.com
• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71872

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• JF Healthcare LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Brick, NJ
  • NPI 1902539406
  Medicare reassignment NPD Authorized official
• Chambers Emergency Associates PA

  • Emergency Medicine Physician
  • Trenton, NJ
  • NPI 1053589614
  Medicare reassignment NPD
• Clare Medical of New Jersey LLC

  • Geriatric Medicine (Family Medicine) Physician
  • Mount Holly, NJ
  • NPI 1255718276
  Medicare reassignment NPD
• Hackensack Meridian Urgent Care, PC

  • Urgent Care Clinic/Center
  • Freehold, NJ
  • NPI 1285165209
  Medicare reassignment NPD
• Ez Mind Family Mental Health LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lanoka Harbor, NJ
  • NPI 1093448599

  Family

  NPD Authorized official
• Ima Urgent Care

  • Urgent Care Clinic/Center
  • Shrewsbury, NJ
  • NPI 1427432244
  NPD (past)
• Northern Ohio Medical Specialists, LLC

  dba NOMS Premium Imaging Center

  • Radiology Clinic/Center
  • Sheffield Village, OH
  • NPI 1508811332
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1558396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1912564428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 MAIN ST STE 1",
            "city": "LANOKA HARBOR",
            "state": "NJ",
            "postal_code": "087342228",
            "telephone_number": "732-719-1920",
            "fax_number": "732-719-1920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 MAIN ST STE 1",
            "city": "LANOKA HARBOR",
            "state": "NJ",
            "postal_code": "087342228",
            "telephone_number": "732-719-1920",
            "fax_number": "732-719-1920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORD",
        "first_name": "JAN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-21",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ00922600",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00922600",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FOR COMMERCIAL INSURANCES",
            "identifier": "26NJ00922600",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "26NJ00922600",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVANCED PRACTICE NURSE",
            "identifier": "26NJ00922600",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "ezmindfamilymentalhealth@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Practice email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "500 Main St Ste 1",
            "city": "Lanoka Harbor",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "087342228",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ez Mind Family Mental Health LLC
• Family Medical Professionals
• Karen L Fink, DPM
• Nathan Fink, O.D.
• Avelina Fernando Flores, MD
• Ronald Fraser, MA
• Marilyn B Gresh, LCSW
• Kavinder Singh Grewal, MD
• Michael Habib, D.M.D.
• Kari Marie Heinze, LSW

• Psychiatric/Mental Health Nurse Practitioner in Lanoka Harbor, NJ
• Providers in Lanoka Harbor, NJ by specialty
• Psychiatric/Mental Health Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.